Prostaglandin (PG)E2 is a major
cyclooxygenase (COX) product that is important in human physiology and pathophysiology. Quantification of systemic PG production in humans is best assessed by measuring excreted urinary metabolites. Accurate and easy-to-perform assays to quantify the major urinary metabolite of
PGE2, 11alpha-hydroxy-9,15-dioxo-2,3,4,5-tetranor-prostane-1,20-dioic
acid (
PGE-M), do not exist. We now report the development of a robust and facile method to measure urinary
PGE-M excretion in humans using stable
isotope dilution techniques employing liquid chromatography/tandem mass spectrometry (LC/MS/MS). Concentrations of the metabolite in urine from healthy humans are nearly twofold greater in men than in women (10.4+/-1.5 vs. 6.0+/-0.7 ng/mg
creatinine). Levels of
PGE-M in healthy humans are suppressed significantly not only by the nonselective COX inhibitor
ibuprofen but also by the COX-2 selective inhibitor
rofecoxib, suggesting that the majority of
PGE2 formed in vivo is derived from COX-2. Increased COX-2 expression and increased
PGE2 production are associated with
malignancy. Levels of
PGE-M were found to be greatly increased in humans with unresectable non-
small cell cancer of the lung, and this increase is dramatically reduced by administration of the
COX-2 inhibitor celecoxib, implying that COX-2 contributes significantly to the overproduction of
PGE2. In summary, quantification of
PGE-M using LC/MS/MS provides a facile and accurate method to assess
PGE2 formation in human physiological and pathophysiological processes.